Dr. Ashish Jha: The problem with quasi-experts

How does one identify a quasi-expert — the intelligent, highly educated and degree-holding opinionators among us, who may stray from their area of expertise? 

It's a question that has complicated and thwarted science communication throughout the pandemic, notes Ashish Jha, MD, dean of Brown University's School of Public Health in Providence, R.I.

In a 42-minute podcast from The New York Times, Dr. Jha discussed several high-level ways he believes medical, scientific and public health communication has gone sideways. 

1. The rise of quasi-experts. Because information is ubiquitous, its consumers face greater choices about judgment and who they trust to sift through it. There's no shortage of experts vying to do so. 

"It has given rise to a bunch of what I think of as quasi-experts: people with good titles who should know better but have used this moment to step in and say, 'Hey I'm a professor at Harvard,'" Dr. Jha said. "Sure you're a professor at Harvard, but you're speaking a lot of nonsense and you don't have any expertise in this topic, because expertise is specific. That is almost impossible for people outside of the medicine and public health world to sort out."

Dr. Jha specifically pointed to Marty Makary, MD, a surgeon and public policy researcher at Baltimore-based Johns Hopkins University, as an example of a quasi-expert who is eager to advise on issues outside of his wheelhouse. 

"He is not afraid to go way beyond his area of expertise. He has never been held back by being wrong. So he says stuff — he had this pronouncement that we were going to hit herd immunity in April 2021. Turned out not so much," Dr. Jha said. "But he's a professor at Hopkins. If you are a normal American, and this is a guy at Hopkins — one of the leading institutions — who seems and is really smart … how do you deal with that? That's the challenge. People are struggling to figure out who are the real experts and who is just making it up."

2. Communication built around how people might react. Dr. Jha said the fear of how words will be misinterpreted has hamstrung health agencies and experts since the pandemic began. Too often, communicators build their message and information around what people might do with it, anticipating the second order effect versus the first. 

"When we didn't have enough masks, we told people not to wear masks because we were worried that there was going to be a run," Dr. Jha said. "Like, no, just level with people — people should wear masks, but we don't have enough, so therefore…"

More recently, he thinks the CDC made the same mistake by leaving out a negative COVID-19 test result to end isolation. "What they should have said is if you can get access to tests and they're negative, you can end isolation safely, but we don't have enough tests right now and so here is plan B. I think people are more than sophisticated enough to handle that. But we always worry that people will misinterpret, they will panic, and that's not how this stuff works."

3. Fear that a simple "I don't know" will open the floodgates of misinformation. Admitting uncertainty in the moment can be the best answer. But Dr. Jha pointed out that leaders or experts often believe "I don't know" creates open grounds for misinformation. 

"I actually don't think that's true at all," he said. "I think being unnecessarily certain, not providing any information at all — those are the grounds for misinformation to come in. I think being open and honest is actually a pretty strong tool against misinformation." 

Listen to Dr. Jha's remarks on the Times' "Sway" here

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